Roman Iulia Ioana, Mocan Teodora, Orasan Meda-Sandra, Jianu Elena Mihaela, Sfrangeu Carmen-Angela, Orasan Remus-Ioan
Physiology Department, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Romania.
Physiopathology Department, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Romania.
Clujul Med. 2018;91(1):42-47. doi: 10.15386/cjmed-813. Epub 2018 Jan 15.
Psoriasis vulgaris, a chronic inflammatory skin disease, requires a long term medication, in order to avoid relapsing episodes. TNF-alpha, one of the targeted molecule in psoriasis therapy, seems to be also involved in thyroid disorders etiopathogenesis. The aim of this study was to evaluate the relationship between anti TNF-alpha therapy and thyroid parameters: serum level of triiodothyronine (T3), free thyroxine (FT4), thyroid-stimulating hormone (TSH) and antithyroidperoxidase antibody (AbTPO) in psoriasis treated population.
The study was performed on 44 patients with psoriasis vulgaris (20 patients under antiTNF-alpha treatment (etanercept), 24 patients with no previous systemic therapy). Serum concentrations of hormones, AbAntiTPO and TNF-alpha were measured and a thyroid ultrasonographic evaluation was performed for each patient.
The mean serum level of FT4 was significantly higher in patients with no systemic treatment (p<0.05). The patients treated with etanercept had a significantly higher level of TNF-alpha (p<0.05). No significant difference was observed for the other evaluated parameters. Also, we found a significant negative correlation between TNF-alpha and TSH levels (r=-0.366, p=0.015).
We only found that the mean level of FT4 was significantly higher in patients with no systemic treatment. Also, a negative strong correlation was seen between serum level of TSH and TNF-alpha. Based on our data, comparison with other anti TNF-alpha therapies might be of interest in future studies.
寻常型银屑病是一种慢性炎症性皮肤病,需要长期用药以避免复发。肿瘤坏死因子-α(TNF-α)是银屑病治疗中的一个靶向分子,似乎也参与了甲状腺疾病的发病机制。本研究的目的是评估抗TNF-α治疗与银屑病患者甲状腺参数之间的关系:血清三碘甲状腺原氨酸(T3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)水平以及抗甲状腺过氧化物酶抗体(AbTPO)。
对44例寻常型银屑病患者进行了研究(20例接受抗TNF-α治疗(依那西普),24例未接受过全身治疗)。测定了患者血清中激素、AbAntiTPO和TNF-α的浓度,并对每位患者进行了甲状腺超声评估。
未接受全身治疗的患者FT4平均血清水平显著更高(p<0.05)。接受依那西普治疗的患者TNF-α水平显著更高(p<0.05)。其他评估参数未观察到显著差异。此外,我们发现TNF-α与TSH水平之间存在显著负相关(r=-0.366,p=0.015)。
我们仅发现未接受全身治疗的患者FT4平均水平显著更高。此外,TSH血清水平与TNF-α之间存在强烈负相关。基于我们的数据,未来研究中与其他抗TNF-α治疗进行比较可能会很有意义。